Apaf-1和Ki-67在乳腺癌组织中的表达及临床意义

目的 探讨凋亡酶激活因子（Apaf-1）和Ki-67在乳腺癌组织中的表达并分析两者表达的临床意义。方法 收集2014年1月至2015年12月60例乳腺癌组织和30例癌旁组织存档蜡块，采用免疫组织化学 EnVision法检测Apaf-1和Ki-67的表达情况，同时分析两者表达的相关性及与临床病理特征（年龄、肿瘤大小、淋巴结转移、临床分期和身体质量指数）的关系。 结果 Apaf-1在乳腺癌组织中的阳性表达率为21.7%（13/60），低于癌旁组织的70.0%（21/30），差异有统计学意义（P<0.05）。Ki-67在乳腺癌组织中的阳性表达率为73.3%（44/60），高于癌旁组织的36.7%（11/30），差异有统计学意义（P<0.05）。两者表达与年龄、身体质量指数均无关（P>0.05），与肿瘤大小、淋巴结转移及临床分期有关（P<0.05）。两者在乳腺癌组织中的表达呈负相关（r=-0.413，P=0.018）。结论 Apaf-1在乳腺癌中表达降低，而Ki-67水平升高，两者在乳腺癌的发展和侵袭中发挥促癌作用，有可能作为临床诊断乳腺癌的标志物。

Expression and clinical significance of Apaf-1 and Ki-67 in breast cancer tissues

Objective To study the expression of apoptotic protease activating facter-1 ( Apaf-1) and Ki-67 in breast cancer tissues and normal breast tissues, and to investigate the clinical significance of the two proteins. Methods From January 2014 to De-cember 2015, paraffin blocks of 60 cases of breast cancer tissues and 30 cases of adjacent normal tissues were enrolled in this study. The expressions of Apaf-1 and Ki-67 were detected using immunohistochemical EnVision method. The relationship between the two pro-teins, as well as the relationship of them with clinicopathological factors( age, tumor size, lymph node metastasis, clinical stage and body mass index) was also analyzed. Results The positive rate of Apaf-1 in breast cancer tissues was 21. 7% ( 13/60) , which was significantly lower than that in adjacent normal tissues (70. 0%, 21/30), and the difference was statistically significant (P<0. 05). The positive rate of Ki-67 in breast cancer tissues was 73. 3% ( 44/60) , which was significantly higher than that in adjacent normal tis-sue (11/30, 36. 7%), and the difference was statistically significant (P<0. 05). Apaf-1 and Ki-67 were not related with age, body mass index( P>0. 05) , but with tumor size, lymph node metastasis and clinical stage ( P<0. 05) . The expression of the two protein in breast cancer tissues was negatively correlated ( r=-0. 413, P=0. 018) . Conclusion In breast cancer, Apaf-1 expression was de-creased but Ki-67 expression was elevated. Apaf-1 and Ki-67 play an important role in the development and invasion of breast cancer, and may be used as a marker to diagnose the breast cancer.